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CVS - SEM2 > Session 4 - Congenital heart defects & cellular and molecular events in CVS > Flashcards

Session 4 - Congenital heart defects & cellular and molecular events in CVS Flashcards

1
Q

What are the 2 types of congenital malformation of the heart & great vessels?

A

Acyanotic & cyanotic

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2
Q

Describe the movement of blood in terms of concentration gradient

A

Travels down the concentration gradient (high to low)
Left to Right

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3
Q

What are acyanotic defects?

A

blood in the systemic circulation is fully saturated with O2 so pO2 is maintained

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4
Q

What are the 6 types of acyanotic defects?

A
  • Atrial septal defect (ASD)
  • Ventricular septal defect (VSD)
  • Patent foramen ovale (PFO)
  • Patent Ductus Arteriosus (PDA)
  • Coarctation of the aorta
  • Atrioventricular septal defect
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5
Q

What is an atrial septal defect (ASD)?

A
  • Opening in septum/wall between 2 atria
  • Blood in LA able to flow to RA so no mixing of deoxygenated blood with the oxygenated blood being pumped around the systemic circulation (body receives O2 - acyanotic)
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6
Q

What is ASD mostly caused by?

A

deformation of the septum primum or septum secundum

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7
Q

What is the problem associated with atrial septal defect (ASD)?

A
  • Blood is able to move from LA to RA due to an opening between atria
  • Increased blood in RA => RV overload => more blood pumped around pulmonary system
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8
Q

What is a ventricular septal defect (VSD)?

A
  • Abnormal opening in the interventricular septum
  • Blood in LV flows into RV
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9
Q

What is VSD caused by?

A

caused by the membranous portion of the septum no developing properly meaning primary interventricular foramen remains open

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10
Q

What is a patent ductus arteriosus (PDA)?

A

Ductus arteriosus connecting right pulmonary artery to arch of aorta remains open (supposed to close when baby takes a first breath)

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11
Q

What occurs in a patent ductus arteriosus?

A

Allows blood under high pressure in aorta to flow into pulmonary artery
=> higher volume of blood in pulmonary artery
=> higher afterload for RV
=> RS failure

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12
Q

What happens if a patent ductus arteriosus is left untreated?

A

Congestive heart failure due to increased return to LS of heart

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13
Q

How are patent ductus arteriosus acyanotic?

A

blood reaching systemic circulation is fully saturated with O2 from lungs

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14
Q

What is the coarctation of the aorta?

A

narrowing of aortic lumen in former ductus arteriosus area

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15
Q

How does coarctation of the aorta lead to LV hypertrophy?

A

Narrowing of the aorta increases afterload of LV causing LV hypertrophy

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16
Q

Which parts of the body are compromised in the coarctation of the aorta? What are the effects?

A

Reduced blood flow to the lower part of the body causes weak pulses & cramping in legs

17
Q

Why is the blood supply to the head & upper limbs not compromised in coarctation of the aorta?

A

the regions are proximal to the coarctation

18
Q

What are the risks of coarctation of the aorta?

A

increased pressure due to narrowing leads to increased risk of aneurysms of aortic arch & aortic root dilation which can lead to aortic valve regurgitation

19
Q

What is atrioventricular septal defect?

A

hole in middle of heart with one common atrioventricular valve instead of mitral and pulmonary valve

20
Q

What is an atrioventricular septal defect caused by?

A

failure of endocardial cushions to develop properly

21
Q

In which disease is the atrioventricular septal defect common?

A

Down’s syndrome

22
Q

What is a cyanotic defect?

A

blood in systemic circulation is NOT saturated with O2 so pO2 is low

23
Q

What are the 6 types of cyanotic defects?

A
  • Tetralogy of Fallot
  • Tricuspid atresia
  • Pulmonary atresia
  • Hypoplastic Left Heart
  • Univentricular Heart
  • Transposition of the Great Arteries
24
Q

What is Tetralogy of Fallot?

A

Group of 4 lesions occurring together as a result of a single development defect

25
Q

Name & describe the 4 lesions of Tetralogy of Fallot?

A
  • Pulmonary stenosis: pulmonary artery or valve is narrowed => less can blood enter
  • Overriding aorta: aorta is situated next to the VSD rather than over LV so most of the blood in the heart flows through it [VSD]
  • VSD: allows blood from RV [which cannot be pumped through stenosed pulmonary artery/valve] to move into LV & is pumped around body via aorta
  • Hypertrophy of RV: caused by attempts to generate more force to pump blood through stenosis into pulmonary artery
26
Q

What is tricuspid atresia?

A

Tricuspid valve fails to form, blood cannot flow from RA to RV (no opening)

27
Q

How does blood continue to flow into pulmonary circulation in tricuspid atresia?

A

ASD & VSD are present

28
Q

What is pulmonary atresia?

A

Pulmonary valve fails to form, blood cannot flow from RV to pulmonary artery & leave heart – only way to leave RS is through a defect

29
Q

How does blood continue to flow into pulmonary circulation in pulmonary atresia?

A

Patent ductus arteriosus allows blood into pulmonary circulation as blood in aorta can flow into pulmonary artery

30
Q

What is a hypoplastic left heart?

A

Mitral or aortic valves are stenosed in utero = less blood flows in LV => LV is underdeveloped

31
Q

How does blood continue to flow into pulmonary circulation in hypoplastic left heart?

A
  • ASD allows blood to flow into RS of heart & pumped into pulmonary artery
  • PDA allows blood to enter aorta from left pulmonary artery
32
Q

What is univentricular heart?

A
  • Ventricular septum doesn’t form
  • Oxygenated & deoxygenated blood mixes in ventricle & gets pumped into both aorta & pulmonary trunk - body doesn’t receive fully oxygenated blood
33
Q

Describe the transposition of the great vessels

A
  • Aorticopulmonary septum forms but does not spiral causing Aorta & Pulmonary artery to be switched in position “transposed”
  • RV connected to aorta & LV connected to pulmonary trunk (instead of the other way around)
34
Q

Why is the transposition of great vessels a cyanotic defect?

A

Deoxygenated blood carried to body via aorta

35
Q

What does the transposition of great vessels result in?

A
  • Results in two unconnected parallel circulations instead of two circulations in series
  • Pulmonary & systemic circulations are separated
36
Q

How does the body still receive blood in the transposition of great vessels?

A

VSD, ASD & patent ductus arteriosus allow blood to mix so some oxygenated blood is pumped to rest of body

37
Q

How does stenosis lead to pulmonary valve?

A
  • One/both semilunar valves don’t develop properly & narrow when baby is born
  • LV/RV hypertrophy as heart is generating more force to push blood through stenosed valve
  • Hypertrophy can lead to heart failure
38
Q

Describe how the resting membrane potential of cardiac cells is generated

A

Selective permeability of the cell membrane to K+ & the concentration gradient for K+ that exists across the cell membrane – approx. 90 mV

K+ ATPase sets up concentration gradient of ions

CVS - SEM2 (4 decks)

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